Free Georgia Psc Employer Assurance Template in PDF
In the landscape of education and professional development within Georgia, the revised June 2021 Georgia PSC (Professional Standards Commission) Employer Assurance Form embodies an essential procedural step for educators seeking to affirm their employment status and qualifications. This form, necessary for educators either currently employed or anticipating employment in Georgia's educational system, serves multiple critical purposes. It is a tool for verifying employment within a public or private school system or agency, ensuring all requisite background checks are complete, and, in certain instances, allowing applicants to be exempt from the certification fee. Furthermore, it facilitates requests for various types of certifications, including but not limited to Permits, International Exchange, Waiver, or non-renewable certificates, each tailored to specific educational roles and needs. The form, which must be submitted electronically through designated platforms for public school employers or uploaded via the MyPSC account for others, underscores the comprehensive and rigorous standards upheld by the Georgia educational system. It reflects a commitment to ethical practice, verification of qualifications, and the facilitation of educators’ professional journeys within the state, emphasizing a dedication to maintaining high standards of educational excellence and integrity.
Form Sample
Georgia PSC Employer Assurance Form – Revised June 2021
DO NOT MAIL!
Public School Employer: Must submit electronic form through www.gapsc.org account
All other GA Employers may complete the form for applicant to upload via MyPSC
This form is to be used to verify current employment as a Georgia educator.
1. Applicant Information |
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Please use dark ink. |
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Title |
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Last Name |
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Mr. Ms. |
Dr. |
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First Name |
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Middle Name |
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GaPSC Certification ID Number |
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Date of Birth (MM/DD/YY) |
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Sections 2, 3, & 4 must be completed by the employer.
2. Employment Verification:
In submitting this form, I certify that all required background checks have been completed for this applicant and any violations of the Georgia Code of Ethics for Educators have been reported to the GaPSC. I also certify that the applicant is/will be working within the local unit of administration (LUA) I represent in a position requiring GaPSC certification and that the applicant is/will be employed by the LUA or by an outside agency contracted by the LUA to provide staffing or educational services.
Employment is in the certification field of : |
Employment in this certificate field began on: |
/
(MM/DD/YY)
/
3. Transaction Request:
I am requesting the following transaction(s) on behalf of the applicant listed above (check all that apply):

First GA certificate (applicant holds professional

Renewal- A PLP/PLG has been established and the educator is making adequate progress toward meeting the plan/goals?
Yes 
No 


Addition of a new field

Conversion or Extension

Upgrade
Montessori certificate 
Educational Interpreter
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Field Code: |
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(see reverse) |
Other unlisted transaction (please specify):
4. Employer Information:
Name of Superintendent or authorized designee (print/type) |
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Signature (eSignature not accepted) |
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Title |
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Date |
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Phone Number |
Email Address |
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Name of Local Unit of Administration (School System / Agency / Private School / Institution)
Initial if applicable: __________ This is a virtual school based outside of Georgia. I certify that the applicant listed above will be working with Georgia students.
EMPLOYER ASSURANCE FORM INSTRUCTIONS – Revised June 2021
Note: Please complete all forms legibly in black ink or type.
The Georgia PSC Employer Assurance Form should accompany all applications for certification when the applicant is employed or will be employed by a Georgia public or private school system/agency. When possible, this form should be submitted electronically through the employer’s account on
www.gapsc.org. This form is used for the following:
To verify that the applicant is currently employed or will be employed in the listed system/agency and all required background checks have been completed;
To exempt the applicant from the certification fee in some cases; and
To request a Permit, International Exchange, Waiver, or
CERTIFICATE FIELD CODES
TEACHING FIELDS
Elementary Fields
Birth Through Kindergarten – 870
Elementary Education
SpEd Gen Curriculum/Elementary Education
–708
Middle Grades
Language Arts - 853
Mathematics - 851
Reading - 855
Science - 852
Social Science - 854
Secondary Fields
Agriculture– 788
Behavioral Science – 766
Biology – 750
Business – 783
Chemistry – 752
Earth/Space Science – 753
Economics – 757
Engineering and Technology – 769
English – 730
Family/Consumer Science – 790
Geography – 759
Healthcare Science – 619
History – 755
JROTC: Air Force – 643
JROTC: Army – 641
JROTC: Marine Corps – 644
JROTC: Navy – 642
Marketing – 792
Mathematics – 743
Physics – 751
Political Science – 756
Science (Broad Field) – 748
Speech – 733
Trade & Industrial Education:
Architectural Drawing and Design – 658
Audio/Video Technology & Film – 652
Automotive Service Tech – 650
Aviation – 830
Barbering – 613
Collision Repair – 653
Computer Animation – 678
Construction - 656
Cosmetology – 525
Culinary Arts - 669
Distribution & Logistics– 654
Electronics Technology – 657
Esthetics – 614
Government & Public Administration– 680
Granite Technology – 659
Graphic Communications & Design – 660
IT/Info Services & Support – 662
IT/Network Systems - 663
IT/Programming & Software Dev. – 664
IT/Cybersecurity – 676
Manufacturing & Engineering Sciences – 667
Marine Service Technology – 618
Nails – 615
Precision Machine Technology – 668
Law, Public Safety, Corrections & Security – 670
Sheet Metal – 671
Welding Technology – 673
Foreign Languages
American Sign Lang. |
832 |
Arabic |
845 |
Chinese (Mandarin) |
834 |
Farsi |
848 |
French |
836 |
German |
838 |
Greek (Classical) |
842 |
Hebrew |
841 |
Hindi |
843 |
Italian |
840 |
Japanese |
831 |
Korean |
846 |
Latin |
835 |
Portuguese |
844 |
Russian |
839 |
Spanish |
837 |
Swahili |
847 |
Turkish |
850 |
Urdu |
849 |
Special Education
Deaf Education – 797
Sp Ed General Curriculum – 798
SpEd General Curriculum/Elementary Education
Learning Disabilities – 777 Physical & Health Disabilities – 768 Sp Ed Preschool (ages
Sp Ed Academic Content Concentrations:
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Language Arts |
930 |
931 |
932 |
Mathematics |
910 |
911 |
912 |
Reading |
950 |
951 |
952 |
Science |
920 |
921 |
922 |
Social Science |
940 |
941 |
942 |
Art – 764
Computer Science – 789
Dance – 820
Drama – 821
Eng. To Speakers of Other Lang. (ESOL) – 885
Gifted
Gifted Concentrations:
Language Arts – 963
Mathematics – 961
Reading – 965
Science – 962
Social Science – 964
Health Education - 760
Health and Physical Education – 761
Music – 767
Reading – 732
SERVICE FIELDS
Audiology – 801
Media Specialist – 813
School Counseling - 709
School Nutrition Director – 729
School Psychology– 711
School Social Work – 715
Speech and Language Pathology – 802
Curriculum & Instruction – 902
Instructional Technology – 903
Teacher Leadership – 904
LEADERSHIP FIELDS
Educational
Educational Leadership- Tier II
ENDORSEMENTS
Teaching Endorsements: Agriculture Education
Birth Through Five – 871
Career Exploration (PECE) – 749 Career Technical Instruction (CTI) – 810 Coaching Endorsement – 980 Computer Science – 882
Coordinated Career Academic Ed (CCAE)
Dramatic Writing
Gifted
Positive Behavior Intervention and Supports (PBIS) – 189
Reading – 833
Safety & Driver Education – 763 Sp Ed Deaf Education – 874
Sp Ed Physical & Health Disabilities – 875 Sp Ed Preschool (ages
Sp Ed Transition Specialist – 873
Sp Ed Visual Impairment – 876 STEM Education – 186 Urban Education – 891
Service Endorsements:
Student Support Team Coordinator – 888 Teacher Support and Coaching – 712
Leadership Endorsements:
Teacher Leader – 774
File Overview
| Fact Number | Fact Description |
|---|---|
| 1 | The form is designed to verify employment for educators in Georgia. |
| 2 | Electronic submission is required via www.gapsc.org for public school employers. |
| 3 | Private and other Georgia employers may complete the form for applicants to upload via MyPSC. |
| 4 | Employers must verify that all required background checks have been completed. |
| 5 | The form plays a role in certifying that an applicant is or will be working in a qualifying position that requires GaPSC certification. |
| 6 | It helps in requesting various transactions such as the first GA certificate, renewal, addition of a new field, and more. |
| 7 | Specific fields and endorsements are listed indicating various teaching, service, and leadership fields recognized by GaPSC. |
Guide to Using Georgia Psc Employer Assurance
Filling out the Georgia PSC Employer Assurance Form is an important step for current or prospective educators in Georgia to verify their employment status, request specific transactions for their certification, and in some cases, waive certification fees. The process requires careful attention to detail and must be completed by both the applicant and the employer. Below are step-by-step instructions to guide you through filling out the form accurately.
- Start by entering the applicant information. This includes selecting the appropriate title (Mr., Ms., Dr.), and writing the applicant's last name, first name, and middle name using dark ink. Also, include the GaPSC Certification ID Number and Date of Birth in MM/DD/YY format.
- Under Employment Verification, the employer must certify that all required background checks have been completed and any violations of the Georgia Code of Ethics for Educators have been reported to the GaPSC. Confirm that the applicant is/will be working in a role requiring GaPSC certification within the represented local unit of administration (LUA), either directly or through an outside agency. Specify the certification field and the date employment in this field began.
- For the Transaction Request section, the employer needs to indicate which transaction(s) are being requested for the applicant by checking all applicable boxes. These could include requests for a first GA certificate, renewal, addition of a new field, conversion or extension, upgrade, Montessori certificate, Educational Interpreter, non-renewable type certificate and field, and any other unlisted transactions. Specify the field code if known.
- In the Employer Information section, print or type the name of the Superintendent or authorized designee and provide their signature (note that eSignature is not accepted). Include the title, phone number, email address, and the name of the Local Unit of Administration. If applicable, indicate whether this employment is with a virtual school based outside of Georgia but working with Georgia students.
Once completed, remember the form should not be mailed. For public school employers, the form must be submitted electronically through the employer’s account on www.gapsc.org. All other Georgia employers are to complete the form for the applicant to upload it via their MyPSC account. Ensuring the form is filled out correctly and entirely is crucial for successfully verifying employment and facilitating any requested transactions related to the educator's certification.
Obtain Clarifications on Georgia Psc Employer Assurance
What is the purpose of the Georgia PSC Employer Assurance Form?
The Georgia PSC Employer Assurance Form is designed to verify the employment status of individuals seeking or holding educational certification in Georgia. It confirms that the applicant is currently employed or will be employed in a position that requires Georgia Professional Standards Commission (GaPSC) certification within the state. Additionally, this form serves to attest that all necessary background checks have been conducted and any ethical violations have been reported. For public school employers, it exempts the certification fee in certain scenarios and is used to request various types of certification, including Permits, International Exchange, Waivers, or non-renewable type certificates.
Who needs to complete the Georgia PSC Employer Assurance Form?
Employers within the Georgia educational system, including public school systems, private schools, agencies, and institutions, must complete this form for candidates employed or being considered for employment in positions requiring GaPSC certification. The form should be filled out by the employer when an educator is applying for initial certification, renewals, upgrades, or additions to their current credentials. It's particularly necessary when the employment directly impacts the certification status of the individual.
How is the Georgia PSC Employer Assurance Form submitted?
Public school employers are required to submit the Employer Assurance Form electronically via their account on www.gapsc.org. For all other types of employers within Georgia's educational system, the form can be completed for the applicant to upload via their MyPSC account. It is important to note that eSignatures are not accepted on this form, hence, a physical signature from the superintendent or authorized designee is necessary before submission.
Are there any specific instructions for filling out the form?
Yes, the form should be completed legibly using black ink or typed. It consists of sections that require detailed applicant information, employment verification, transaction request, and employer information. Employers must ensure that they have conducted the necessary background checks and report any ethics violations to the GaPSC. The form also includes sections for requesting specific transactions related to the applicant’s certification, such as renewals or additions of new fields.
What happens if the form is not submitted correctly?
If the Georgia PSC Employer Assurance Form is not submitted correctly or completely, it may result in delays or complications in the processing of certification requests. Incomplete forms or forms with incorrect information can hinder an applicant’s certification status, impacting their eligibility for employment in certain positions within the Georgia education system. It is essential for employers to review the form thoroughly before submission to ensure all information is correct and complete.
Can the Georgia PSC Employer Assurance Form exempt an applicant from the certification fee?
Yes, in some cases, the completion of the Georgia PSC Employer Assurance Form can exempt an applicant from the certification fee. This is typically applicable to individuals employed by public schools within Georgia. The form serves as a verification of employment in a qualified position, which can qualify the applicant for a fee exemption depending on the specific requirements and circumstances outlined by the GaPSC.
Common mistakes
Filling out the Georgia PSC Employer Assurance Form is a critical step in the certification process for educators in Georgia. However, mistakes can occur during this process, leading to delays or complications. Here are ten common mistakes to avoid when completing this form:
- Not using dark ink or typing: The form instructs that all entries should be made legibly in black ink or typed. Using lighter inks can make the form hard to read and process.
- Omitting the GaPSC Certification ID Number: This is a crucial piece of information that uniquely identifies the applicant. Skipping this can result in processing delays.
- Incomplete employment information: Sections 2, 3, and 4 must be completely filled out by the employer. Missing details in these sections could lead to the form being returned or unprocessed.
- Invalid eSignature: The form explicitly states that an electronic signature (eSignature) is not accepted. An original signature from the Superintendent or an authorized designee is required.
- Checking the wrong transactions: Failing to correctly identify and check the appropriate box in section 3 for the requested transaction may lead to incorrect processing.
- Forgetting to report violations: It is the employer’s responsibility to report any violations of the Georgia Code of Ethics for Educators. Overlooking this can have serious implications.
- Not specifying the employment field correctly: The job role or certification field must be clearly indicated, including the correct field code, to ensure the certification matches the educator's employment.
- Failing to confirm background checks: The form is used to verify that all required background checks have been completed. Not confirming this can result in certification delays.
- Incorrect contact information: Providing outdated or incorrect contact details in the employer information section can hinder communication regarding the form.
- Not indicating a virtual school correctly: For virtual schools based outside of Georgia but serving Georgian students, failing to initial the appropriate line can cause confusion about the applicability of Georgian standards.
To ensure a smooth processing experience, it's important to pay close attention to these details. Simple mistakes can be easily avoided by thoroughly reviewing the form instructions and double-checking all entered information before submission.
Documents used along the form
When navigating the certification process for educators in Georgia, the Georgia PSC Employer Assurance Form is a significant document, but it represents just one piece of the puzzle. Educational professionals often find themselves needing to gather a variety of forms and documents to ensure a smooth pathway to certification, employment, and professional development. Here is a list of other commonly required documents and forms that may accompany the Georgia PSC Employer Assurance Form:
- Official Transcripts: These documents provide proof of academic achievements and are required to verify that the educator has obtained the necessary qualifications from accredited institutions.
- Background Check Authorization Form: This form authorizes the Georgia Professional Standards Commission (GaPSC) and/or the employing educational entity to conduct a background check as part of the certification process and employment requirement.
- Code of Ethics for Educators Acknowledgement Form: Educators are often required to sign this form to acknowledge their understanding and commitment to adhere to the Georgia Code of Ethics for Educators.
- Experience Verification Form: For educators claiming work experience, this form is used to verify previous employment in educational settings, whether in Georgia, out-of-state, or internationally.
- Out-of-State Certification Form: Educators who are certified in another state and seeking certification in Georgia must provide documentation of their out-of-state credentials.
- Content Assessment Scores: These are required to demonstrate proficiency or passed examinations in specific subject areas, if applicable.
- Exceptionality Documentation: For those applying for special education positions, documentation detailing qualifications and expertise in working with specific exceptionalities may be required.
- Induction Program Completion Certificate: New educators or those in certain specialized programs may need to show completion of an induction program, which supports their transition into the teaching profession.
- Professional Development Records: Ongoing education and professional development are vital in this field. Documentation of completed workshops, seminars, and classes may be needed for certification upgrade or renewal.
- Personal Affidavit or Statement of Citizenship: An affidavit proving lawful presence or citizenship in the United States is sometimes necessary to comply with state laws governing public employment.
Each of these documents plays a crucial role in the overarching process of educator certification and employment in Georgia. Prospective and current educators should prepare these forms with care, ensuring accuracy and completeness, to facilitate their professional journey in an educational environment. This documentation not only supports individuals in meeting regulatory requirements but also in advancing their careers within the Georgia educational system.
Similar forms
The Teacher Certification Application Form shares similarities with the Georgia PSC Employer Assurance Form as both are utilized in the process of verifying an educator's qualifications and eligibility for certification or licensure in their respective fields. They require detailed employer verification to ensure the applicant meets all necessary educational and ethical standards for the position sought.
The Background Check Authorization Form is akin to the Georgia PSC Employer Assurance Form in that it requests the completion of background checks for the applicant. Both forms necessitate employers or authorized signatories to certify that proper background investigations have been conducted to maintain accountability and safety within the educational environment.
The Employment Verification Form closely resembles the section of the Georgia PSC Employer Assurance Form dedicated to verifying current employment status. Both documents are vital for affirming an individual's employment in a specific role, assuring that the candidate is actively engaged in a position that aligns with their qualifications and certification requirements.
Similar to the Georgia PSC Employer Assurance Form, the Professional Learning Plan (PLP) Progress Report Form is used in educational settings to document and assess progress towards specific educational or certification goals. Both forms facilitate the evaluation of educators' ongoing professional development and competencies in their specialized field.
The Certificate Renewal Application Form parallels the Georgia PSC Employer Assurance Form in its function to facilitate renewal requests for educational certifications. It includes sections for employment verification and certification status, ensuring that educators remain qualified to teach within the state by meeting all updated professional development requirements.
The Educator Ethics Violation Report Form shares a common purpose with the PSC Employer Assurance Form, particularly in the aspects of certifying an educator’s adherence to ethical standards. Both require the reporting of any violations, upholding the integrity of the profession and ensuring that educators maintain high ethical standards.
Similar to sections within the Georgia PSC Employer Assurance Form, the New Field Addition Request Form is used by educators seeking to add a new certification area or specialization to their credentials. This process involves verifying current employment and alignment of the new field with the educator's existing qualifications and employment setting.
The Non-Renewable Certificate Application Form is akin to specific parts of the Georgia PSC Employer Assurance Form that address requests for various non-renewable certifications. Both types of documents are essential for educators who require specific temporary permissions to teach in fields or roles while meeting full certification prerequisites.
The Educational Service Agency (ESA) Endorsement Form resembles the employer assurance form as both are employed to endorse educators for specific roles or certifications. These documents verify that the applicant is working in a capacity that matches their qualifications and is supported by the employing agency or school system.
The Virtual School Employment Verification Form is particularly similar to the section of the Georgia PSC Employer Assurance Form pertaining to virtual school educators. It specifically verifies employment of educators in virtual settings, ensuring they are appropriately certified and qualified to teach Georgia students in an online environment.
Dos and Don'ts
When completing the Georgia PSC Employer Assurance Form, it is crucial to follow specific dos and don'ts to ensure the process is smooth and your submission is successful. Given the importance of this form in verifying employment and facilitating teacher certification in Georgia, paying close attention to detail cannot be overstated. Here are some guidelines to help you along the way:
- Do use dark ink if filling out the form by hand. This makes your information clear and readable, which is important for processing.
- Do complete the form legibly. Whether typing or writing by hand, clarity is key to avoid delays in processing.
- Do check all the applicable boxes in Section 3 under Transaction Request to accurately convey the support you are providing to the applicant.
- Do ensure all required fields are filled out. Incomplete forms may result in processing delays or outright rejection.
- Do verify that all background checks have been completed before certifying employment verification in Section 2.
- Don't mail the form if you are a public school employer. The form must be submitted electronically through the GA PSC website.
- Don't use an electronic signature. The form specifies that eSignatures are not accepted, so a handwritten signature is required.
- Don't ignore the instruction about certifying any violations of the Georgia Code of Ethics for Educators. Ensuring compliance is crucial.
By following these guidelines, you'll be doing your part to ensure the process is efficient and that the educator's certification moves forward without unnecessary hindrance. Remember, the accuracy and completeness of the information provided are paramount in helping educators begin or continue their teaching careers in Georgia.
Misconceptions
Many people have misunderstandings about the Georgia PSC (Professional Standards Commission) Employer Assurance Form, which can cause confusion or errors when completing or submitting the document. Let's clarify some of these misconceptions to help educators and employers navigate the process more smoothly.
- Misconception 1: The form must be mailed to the GaPSC.
- Misconception 2: The form is only for public school employees.
- Misconception 3: An eSignature is acceptable for the form's completion.
- Misconception 4: The form is only relevant for verifying current employment.
This is incorrect. As clearly stated at the beginning of the document, public school employers are required to submit the form electronically through their account on www.gapsc.org. For all other Georgia employers, they may complete the form for the applicant, who will then upload it via their MyPSC account. No physical mailing of the form is necessary or accepted.
While it's true that the form is primarily used by public school employers, it explicitly states that all other Georgia employers may also use it for applicants planning to work in educational positions. This includes private schools, agencies, and institutions, broadening the scope of the form's applicability beyond public education systems.
Despite the growing acceptance of electronic signatures for many types of documents, the Georgia PSC Employer Assurance Form specifies that eSignatures are not accepted. The form requires a handwritten signature from the Superintendent or authorized designee to confirm the authenticity and personal acknowledgment of the information provided.
This form serves multiple purposes beyond simply verifying an applicant's current employment status. It is also used to exempt certification fees in some cases and to request various types of certificates, such as Permits, International Exchange, Waiver, or non-renewable type certificates. This multipurpose nature of the form makes it a critical tool in the certification process for Georgia educators.
Understanding these key points can help eliminate confusion and streamline the certification process for Georgia educators and their employers, ensuring that all steps are completed efficiently and correctly.
Key takeaways
Completing the Georgia PSC Employer Assurance form accurately is vital for educators in Georgia to verify their current employment status and meet certification requirements. Below are key takeaways to guide you through this process:
- The Georgia PSC Employer Assurance Form is crucial for verifying an educator's employment status within a Georgia educational institution and ensuring all necessary background checks are completed.
- Public school employers must submit this form electronically through their account on www.gapsc.org, demonstrating a move towards streamlining the verification process digitally.
- For educators not employed by a public school, the form can still be filled out and then uploaded by the applicant via their MyPSC account, offering flexibility in the submission process.
- Employers are responsible for verifying the applicant's employment in a Georgia-local unit of administration (LUA) or through an external agency providing educational services to an LUA, underlining the importance of accurate employer information on the form.
- The form serves multiple purposes beyond employment verification. It can exempt certain applicants from certification fees and is used for requesting specific types of certification such as Permits, International Exchanges, Waivers, or non-renewable certificates, showcasing the form’s multifaceted utility.
- To complete the form, utilizing dark ink or typing is advised for clarity, ensuring that the information is legible and processed efficiently.
- Employers must select the relevant transaction request on behalf of the applicant, which can include first-time certification, renewal, addition of fields, and more, indicating a comprehensive approach to educator certification.
- The form cannot accept electronic signatures, requiring a physical signature from the superintendent or authorized designee, which emphasizes the formal verification process and the importance of the document's integrity.
Understanding these takeaways ensures that the Georgia PSC Employer Assurance Form is filled out accurately and completely, facilitating a smoother certification process for Georgia educators and maintaining the high standards of the educational system.
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